Response to SARS-CoV-2 vaccination in immune mediated inflammatory diseases: Systematic review and meta-analysis.
Response to SARS-CoV-2 vaccination in immune mediated inflammatory diseases: Systematic review and meta-analysis.
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DOI：
10.1016/j.autrev.2021.102927
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发表时间：
2022-01
影响因子：
13.6
通讯作者：
Sebastian S
中科院分区：
文献类型：
--
作者：
Jena A;Mishra S;Deepak P;Kumar-M P;Sharma A;Patel YI;Kennedy NA;Kim AHJ;Sharma V;Sebastian S
COVID-19 的治疗通常使用免疫调节药物。这些药物还用于治疗免疫介导的炎症性疾病（IMID）。我们对 IMID 患者接种 SARS-CoV-2 疫苗后的血清转化以及各种药物对血清转化率的影响进行了系统评价。检索电子数据库以确定报告 IMID 中 SARS-CoV-2 疫苗接种后血清转化率的相关研究。我们计算了单剂或两剂疫苗接种后的汇总血清转化率、具有特定 IMID 的患者的汇总血清转化率以及使用各种药物/药物类别的患者的血清转化率。系统评价中纳入了 25 项研究。与单剂疫苗接种 (69.3, 52.4–82.3, I2 = 95%) 相比，两剂 mRNA 疫苗接种后的汇总血清转化率更高 (83.1, 95% CI: 74.9–89.0, I2 = 90%)。与健康对照相比，IMID 的血清转化几率较低（0.05、0.02–0.13、I2 = 21%）。炎症性肠病（95.2，95% CI：92.6–96.9，I2 = 0%）、脊柱关节病（95.6，95% CI：83.4–98.9，I2 = 35%）和系统性红斑狼疮（90.7，95% CI： 85.4–94.2，I2 = 0%）高于类风湿性关节炎（79.5，95% CI：65.1–88.9，I2 = 85%）和血管炎（70.5，95% CI：52.9–83.5，I2 = 51%）。在接受抗肿瘤坏死因子 (TNF)、抗整合素 (维多珠单抗)、抗 IL 17 (苏金单抗)、抗 IL6 (托珠单抗) 和抗 IL12/23 (Ustekinumab) 治疗的患者中，双剂量 mRNA 后的血清转化率非常出色 (>90%)，但在接受抗 CD20 (利妥昔单抗) 或抗细胞毒性药物治疗的患者中，血清转化率减弱 (<70%) T 淋巴细胞相关抗原 (CTLA-4) 疗法（阿巴西普）。类固醇、羟氯喹、JAK抑制剂、吗替麦考酚酯和来氟米特的血清转化率良好（70-90%）。与抗 TNF 单一疗法相比，抗 TNF 与免疫调节剂（硫唑嘌呤、6-巯基嘌呤、甲氨蝶呤）的组合导致疫苗反应减弱。 IMID 患者接种 SARS-CoV-2 疫苗后的血清转化率较低。某些疗法（抗 TNF、抗整合素、抗 IL 17、抗 IL6、抗 12/23）不会影响血清转化率，而其他疗法（抗 CD20、抗 CTLA-4）则导致反应较差。
The treatment for COVID-19 often utilizes immune-modulating drugs. These drugs are also used in immune mediated inflammatory diseases (IMIDs). We performed a systematic review about seroconversion after SARS-CoV-2 vaccination in patients with IMIDs and impact of various drugs on seroconversion rates. Electronic databases were searched to identify relevant studies reporting seroconversion rates following SARS-CoV-2 vaccination in IMIDs. We calculated the pooled seroconversion rates after a single or two doses of vaccination, pooled seroconversion rates in patients with specific IMIDs, and rates in patients on various drugs/drug classes. Twenty-five studies were included in the systematic review. The pooled seroconversion rates after two doses of mRNA vaccination were higher (83.1, 95%CI: 74.9–89.0, I2 = 90%) as compared to a single dose (69.3, 52.4–82.3, I2 = 95%). The odds of seroconversion were lower in IMIDs as compared to healthy controls (0.05, 0.02–0.13, I2 = 21%). The seroconversion rates in patients with inflammatory bowel disease (95.2, 95%CI: 92.6–96.9, I2 = 0%), spondyloarthropathy (95.6, 95% CI: 83.4–98.9, I2 = 35%), and systemic lupus erythematosus (90.7, 95%CI: 85.4–94.2, I2 = 0%) were higher as compared to rheumatoid arthritis (79.5, 95% CI: 65.1–88.9, I2 = 85%), and vasculitis (70.5, 95% CI: 52.9–83.5, I2 = 51%). The seroconversion rates following double dose of mRNA were excellent (>90%) in those on anti-tumour necrosis factor (TNF), anti-integrin (vedolizumab), anti-IL 17 (secukinumab), anti-IL6 (Tocilizumab) and anti-IL12/23 (Ustekinumab) therapies but attenuated (<70%) in patients on anti-CD20 (Rituximab) or anti-cytotoxic T lymphocyte associated antigen (CTLA-4) therapies (Abatacept). The seroconversion rates were good (70–90%) with steroids, hydroxychloroquine, JAK inhibitors, mycophenolate mofetil and leflunomide. Combination of anti-TNF with immunomodulators (azathioprine, 6-meracptopurine, methotrexate) resulted in an attenuated vaccine response as compared to anti-TNF monotherapy. Seroconversion rates after SARS-CoV-2 vaccination are lower in patients with IMIDs. Certain therapies (anti-TNF, anti-integrin, anti-IL 17, anti-IL6, anti-12/23) do not impact seroconversion rates while others (anti-CD20, anti-CTLA-4) result in poorer responses.
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影响因子：
27.4
作者：
Mrak, Daniel;Tobudic, Selma;Bonelli, Michael
通讯作者：
Bonelli, Michael
BNT162B2 mRNA COVID-19疫苗的安全性和功效。
DOI：
10.1056/nejmoa2034577
发表时间：
2020-12-31
期刊：
The New England journal of medicine
影响因子：
--
作者：
Polack FP;Thomas SJ;Kitchin N;Absalon J;Gurtman A;Lockhart S;Perez JL;Pérez Marc G;Moreira ED;Zerbini C;Bailey R;Swanson KA;Roychoudhury S;Koury K;Li P;Kalina WV;Cooper D;Frenck RW Jr;Hammitt LL;Türeci Ö;Nell H;Schaefer A;Ünal S;Tresnan DB;Mather S;Dormitzer PR;Şahin U;Jansen KU;Gruber WC;C4591001 Clinical Trial Group
通讯作者：
C4591001 Clinical Trial Group
影响因子：
2.7
作者：
Munn, Zachary;Barker, Timothy Hugh;Aromataris, Edoardo
通讯作者：
Aromataris, Edoardo
影响因子：
5.1
作者：
Liu Y;Sawalha AH;Lu Q
通讯作者：
Lu Q
DOI：
10.1056/nejmoa2035389
发表时间：
2021-02-04
期刊：
The New England journal of medicine
影响因子：
--
作者：
Baden LR;El Sahly HM;Essink B;Kotloff K;Frey S;Novak R;Diemert D;Spector SA;Rouphael N;Creech CB;McGettigan J;Khetan S;Segall N;Solis J;Brosz A;Fierro C;Schwartz H;Neuzil K;Corey L;Gilbert P;Janes H;Follmann D;Marovich M;Mascola J;Polakowski L;Ledgerwood J;Graham BS;Bennett H;Pajon R;Knightly C;Leav B;Deng W;Zhou H;Han S;Ivarsson M;Miller J;Zaks T;COVE Study Group
通讯作者：
COVE Study Group